“There’s good news and there’s bad news…”
So which would you ask for first?
When confronted with that scenario in the cardiologist’s office, I went straight for the jugular. Give me the “bad news” first. And then I lapsed into such a deep shock at that first “results” appointment, I didn’t have the presence of mind to grasp, and even celebrate, all the good news. And there was plenty.
Yes, yes, I’m soon to be having open heart surgery to remove a tumor in my right atrial. A tumor I was “most likely born with” but has now grown to become a nuisance that must be removed. Definitely a case of “ignorance is bliss,” I was going merrily along, living my life, unaware that this tumor… polyp… ugly muffin top… call it what you will, was on the verge of turning me into a blithering puddle of senseless babble, all of which starts with “WHAT IF?”
All that aside, the “GOOD NEWS,” now that I have taken a step back and a deep breath to assist me in hearing more acutely, is this:
So would you just look at all those positives?? Other than an errant myxoma, my heart’s in pretty darn good shape, and taking out the little bugger will be a lot like taking out a gall bladder… except for the lengthier recovery time. They’ll take it out, I’ll mend, and then I’ll go on with my life even better than before.
That’s the plan, and I’m sticking to it.
“So tell me again—” I asked the cardiologist. “Just how big is the myxoma?”
The cardiologist began speaking as he waited for the information to come up on his computer screen. “Last week, when we did the regular Echocardiogram, we had tentative measurements, but by doing the Transesophageal Echo and the CAT scan we were able to get a much better idea of its size.”
He paused while he clicked the mouse a few more times. “The TEE measurement is 3.3 x 2.2 centimeters, and the CAT scan, which is probably the most accurate, is 3.2 x 1.8 centimeters.”
I know enough about the metric system to know that 2.5 centimeters is about an inch. So this “hopefully benign” tumor living in the right side of my heart—up in the atrial—is about an inch and a quarter long and three-quarters of an inch wide, tethered to the septum between the upper chambers.
“It’s like an elongated ping-pong ball,” said the doctor. “With every pump of your heart, it bounces back and forth.”
I’m sure I turned 50 shades of pale.
“Don’t worry,” he continued, “it’s not going to tear loose. It’s going to take a surgeon’s knife to get it out of there.”
Swell. Just swell. And the alternative is to do nothing but “hope” that the tumor, roughly the size of the last joint of my thumb, never gets enough congealed blood on it to create prime conditions for a cardiac arrest.
So today I’m taking copious amounts of iron and folic acid and vitamin C and blood thinners and so forth in preparation for a very unexpected intrusion into my chest cavity. At least it will be under “controlled” circumstances and not as the result of an “attack” of any sort.
And for that, I’m very grateful.
Moments before my “TEE”—Transesophogeal Echocardiogram—I took inventory of those in my curtained cubicle. Kat (short for Kathleen) was in charge of the IV sedation. Bryant had the controls on the monitor for the scope that the doctor would soon be putting down my throat. When Todd, my regular clinic nurse, popped in, I asked him what his official function was.
“Moral support,” he said with a cheery smile. “What do you need?”
From somewhere deep inside me a little voice replied, “Please hold my toes.”
Todd immediately took hold of both my feet, which were covered by a blanket, but still accessible. “How’s that?” he asked, giving them a solid squeeze.
Tears started running down my cheeks.
Years ago, when I began attending all Rick’s cardio doctor appointments and procedures, he had always asked me to hold his toes. I thought the request was a little odd, but did his bidding without question. Now, when the tables were turned, and it was my time to submit to the scans and probes, I found myself automatically reciting his words.
And when Todd took hold of my toes, a sudden wave of calm washed over me. A wave of peace—the comfort and compassion of human connection. I knew without a doubt there was a human being in the room who cared more about my emotional well-being than about any of the numbers on a beeping digital monitor.
“I’ll stay with you until you fall asleep,” said Todd, “but I’ll be gone when you wake up. I have to go to work, but you’re in good hands.”
The warmth in his words was almost as palpable as the warmth I could feel in my feet.
“Thank you,” I whispered as I drifted off. “Now I understand.”
Patience is not my strong suit. Never has been. I want what I want when I want it. Give me instant gratification!
But life is rarely like that. Today I sit here, completely immobilized by the great “unknown.” I feel like I’m living in a foggy world called “Limbo,” which spans the space on my life map between medical testing results and scheduling open heart surgery.
I have no concentration. No motivation. No energy for the daily tasks that might actually be able to distract me for a little while. How ironic that although I have the time, I cannot make myself work on my next book, start figuring out my taxes, or even clean my office!
What if? What if? What if?
On Friday, I had the “TEE”, the transesophogeal echocardiagraphy. It took 4 tries (big bruises on the backs of both hands and inner elbows) to get a good IV going, but after that, I was in la-la land. Afterward, the doctor told me the heart tumor (yes, it IS a tumor) is bigger than what it had appeared during Wednesday’s ECG, and that “the only place for a tumor that size is in the surgeon’s pan.”
I had thought about this possibility all night, so I did not hesitate to say Yes to the surgery to remove it. Then the doctor had me have a chest CAT scan, in which they injected ‘stuff’ into my veins and then ran my torso back and forth through something that looked a lot like an MRI tube, while I held my hands over my head.
I was TOLD the surgeon in Portland would call that day to schedule either an appointment to meet me, or just to go ahead and put the surgery on his schedule. As of this moment, 6:30 a.m. on Monday, I have not heard a thing.
I spent my weekend trying to figure out how to get through the next eight weeks—two months!—without the use of my arms to push myself up out of a chair to stand. Or lift them over my head to wash my hair. Or reach “behind me” to wipe my bottom. And have you ever tried to get dressed without reaching over your head or behind you to find the second sleeve?
The sternum must not be compromised in any way. No lifting, pushing, twisting, reaching. I won’t be driving for eight weeks. I watched Rick struggle with all this, and I am scared spitless. I cry often.
Heart problems of my own were never on my radar.
But first things first, and I need the surgery on the calendar in ink. And THAT is completely out of my control. A great time to practice patience…
But didn’t I mention at the start of this blog that patience is not my strong suit?
In all likelihood, I have a right atrial myxoma: a (hopefully) benign cardiac tumor attached to the septum separating the two upper chambers of my heart. They rarely see such a thing on the right side of the heart. Had it been located on the left, it would have created serious symptoms long before now.
The cardio doctor called it a “serendipitous finding;” I call it a nightmare.
Yesterday I went into the clinic to have a stress test and an echocardiogram (ECG) to give the doctor a better idea of the extent of the structural damage from my recently-diagnosed atrial fibrillation.
I “passed” the stress test just fine, with a little huffing and puffing on the uphill treadmill, but no chest pains whatsoever. I thought I’d gotten all green lights on the ECG as well, but this morning I got the call that puts ice water into your veins: “The doctor needs to see you today, and you need to clear your schedule for a hospital procedure tomorrow morning.”
So this afternoon I saw for myself the ultrasound images of my 1.4 x 1.6 centimeter tumor flopping around inside my heart like a little ping-pong ball. “The biggest I’ve seen in 20 years,” said the cardio doc.
And tomorrow I’ll have a “TEE,” a transesophageal echocardiography, which means they’re going to sedate me and put a scope down my throat to get a closer look at my “alleged” tumor, although the doctor said in his estimation it’s a 99% chance of tumor and 1% chance of being a blood clot.
If it turns out it IS a tumor, then it’s likely I’ll be scheduled to meet a heart surgeon in the very near future, with open heart surgery the most likely option. While they’re in there anyway, it might be possible to do a surgical maze at the same time, which would correct my A-fib. I’d still have to take blood thinners and blood pressure meds for the rest of my life, but those 6 to 8 unnerving daily episodes of my heart doing a wild variation of the jitterbug would cease.
Naturally, I’m scared spitless about THE GREAT UNKNOWN. I keep trying to focus on ONE DAY AT A TIME, and not get the cart too far out in front of the horse, but Holy Shit—Open heart surgery??? On ME??? How could this possibly have happened?
The doctor said it’s likely I was born with this tumor, but that now it’s grown to a point where something must be done to prevent it from interfering with the valve it’s precariously close to. IF it’s a tumor, it needs to go.
And on some level, when I’m feeling just a little bit “spiritual,” I’m wondering if perhaps Rick sent me the A-fib so that I’d get off my fanny and into the doctor for these tests that have “serendipitously” pointed out a much deeper heart problem than I could have ever imagined.
Meanwhile, there was also some undeniably “good” news. There is NO fluid around the heart, the valves all look good, none of the chambers are significantly enlarged, and (at this time), I do NOT have congestive heart failure.
So tonight while I’m breathing a sigh of relief over the good news, I’m also terrified about all the “what if” and “what is” possibilities coming straight at me. A little knowledge is a dangerous thing…